Mally Pradeep Vittal, Agathis Nickolas Theophilos, Bailey Sean Michael
New York University School of Medicine, New York University Langone Medical Center, New York, NY, USA.
World J Pediatr. 2016 Feb;12(1):76-81. doi: 10.1007/s12519-015-0049-8. Epub 2015 Nov 7.
Increasing evidence is demonstrating that infants born early on during the term period are at increased risk of morbidity compared with infants born closer to a complete 40 week gestational pregnancy. The purpose of this study was to compare early term [gestation age (GA): 37-37 6/7 weeks] neonatal outcomes with those of other full term neonatal intensive care unit (NICU) admissions.
Retrospective chart review of all term infants admitted to the NICU at New York University Langone Medical Center over a 17 month period. Subjects were grouped and analyzed according to their GA at birth: 1) early term infants (GA between 37 0/7 to 37 6/7 weeks) and 2) other term infants (38 0/7 weeks and older).
Early term infants were more likely to require NICU care than other term infants [relative risk: 1.42, 95% confidence interval (CI)=1.07-1.88), P=0.01]. In the NICU, they are more likely to manifest respiratory distress syndrome [odds ratio (OR)=5.7, 95% CI=1.6-19.8, P<0.01] and hypoglycemia (OR=4.6, 95% CI=2.0-10.4, P<0.001). In addition, early term neonates were more likely to be born via elective cesarean section than other term neonates (OR=4.1, 95% CI=2.0-8.5, P<0.001).
Being born at early term is associated with increased risk of respiratory disease and hypoglycemia requiring neonatal intensive care. Further efforts directed at decreasing early term deliveries may be warranted.
越来越多的证据表明，与足月妊娠接近40周出生的婴儿相比，足月期早期出生的婴儿发病风险增加。本研究的目的是比较早期足月（胎龄[GA]：37 - 37⁶/₇周）新生儿与其他足月新生儿重症监护病房（NICU）收治患儿的结局。
对纽约大学朗格尼医学中心17个月期间收治入NICU的所有足月婴儿进行回顾性病历审查。根据出生时的GA将受试者分组并分析：1）早期足月婴儿（GA在37⁰/₇至37⁶/₇周之间）和2）其他足月婴儿（38⁰/₇周及以上）。
早期足月婴儿比其他足月婴儿更需要NICU护理[相对风险：1.42，95%置信区间（CI）=1.07 - 1.88，P = 0.01]。在NICU中，他们更易出现呼吸窘迫综合征[比值比（OR）=5.7，95% CI = 1.6 - 19.8，P < 0.01]和低血糖（OR = 4.6，95% CI = 2.0 - 10.4，P < 0.001）。此外，早期足月新生儿比其他足月新生儿更可能通过择期剖宫产出生（OR = 4.1，95% CI = 2.0 - 8.5，P < 0.001）。
早期足月出生与需要新生儿重症监护的呼吸系统疾病和低血糖风险增加相关。可能需要进一步努力减少早期足月分娩。
